Dataset Information

Primary Care Pracitioner Perspectives on the Role of Primary Care in Dementia Diagnosis and Care.

ABSTRACT:

Importance

Although the barriers to dementia care in primary care are well characterized, primary care practitioner (PCP) perspectives could be used to support the design of values-aligned dementia care pathways that strengthen the role of primary care.

Objective

To describe PCP perspectives on their role in dementia diagnosis and care.

Design, setting, and participation

In this qualitative study, interviews were conducted with 39 PCPs (medical doctors, nurse practitioners, and doctors of osteopathic medicine) in California between March 2020 and November 2022. Results were analyzed using thematic analysis.

Main outcomes and measures

Overarching themes associated with PCP roles in dementia care.

Results

Interviews were conducted with 39 PCPs (25 [64.1%] were female; 16 [41%] were Asian). The majority (36 PCPs [92.3%]) reported that more than half of their patients were insured via MediCal, the California Medicaid program serving low-income individuals. Six themes were identified that convey PCPs' perspectives on their role in dementia care. These themes focused on (1) their role as first point of contact and in the diagnostic workup; (2) the importance of long-term, trusting relationships with patients; (3) the value of understanding patients' life contexts; (4) their work to involve and educate families; (5) their activities around coordinating dementia care; and (6) how the care they want to provide may be limited by systems-level constraints.

Conclusions and relevance

In this qualitative study of PCP perspectives on their role in dementia care, there was alignment between PCP perspectives about the core values of primary care and their work diagnosing and providing care for people living with dementia. The study also identified a mismatch between these values and the health systems infrastructure for dementia care in their practice environment.

SUBMITTER: Sideman AB

PROVIDER: S-EPMC10539983 | biostudies-literature | 2023 Sep

REPOSITORIES: biostudies-literature

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Publications

Primary Care Pracitioner Perspectives on the Role of Primary Care in Dementia Diagnosis and Care.

Sideman Alissa Bernstein AB Ma Melissa M Hernandez de Jesus Alma A Alagappan Cecilia C Razon Na'amah N Dohan Daniel D Chodos Anna A Al-Rousan Tala T Alving Loren I LI Segal-Gidan Freddi F Rosen Howie H Rankin Katherine P KP Possin Katherine L KL Borson Soo S

JAMA network open 20230905 9

<h4>Importance</h4>Although the barriers to dementia care in primary care are well characterized, primary care practitioner (PCP) perspectives could be used to support the design of values-aligned dementia care pathways that strengthen the role of primary care.<h4>Objective</h4>To describe PCP perspectives on their role in dementia diagnosis and care.<h4>Design, setting, and participation</h4>In this qualitative study, interviews were conducted with 39 PCPs (medical doctors, nurse practitioners, ...[more]

PMID: 37768660

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Project description:ObjectivesTo understand dementia care providers' perspectives on high-quality care for persons living with dementia (PLWD) in long-term care (LTC).DesignA qualitative study using a directed content analysis approach.Setting and participantsNine national LTC dementia care providers.MethodsWe facilitated 5 listening sessions centered around dementia care philosophies, models, and practices. Two researchers first mapped qualitative data to the Holistic Approach to Transformational Change (HATCh) model for dementia care using a directed content analysis approach. They then identified themes and subthemes emerging from the data using a conventional analysis approach. They coded data iteratively and solicited input from 3 additional researchers to reach consensus where needed. Member checks were performed to ensure the trustworthiness of the data during 2 follow-up listening sessions.ResultsThe 9 participants described the importance of understanding the experiences of PLWDs in order to provide high-quality dementia care and to deliver such care with the residents and their preferences as the focus. They emphasized experiential education as essential for families and all staff, regardless of role. They noted the need to balance safety with resident choice, as well as the corresponding need for facility leadership and regulators to support such choices. The listening sessions revealed areas to foster person-centered care for PLWD, but also highlighted barriers to implementing this philosophy in LTC settings.Conclusions and implicationsEmergent themes included care practices that center on resident preferences and are supported by staff with the experiential education and communication skills necessary to relate to and support PLWD. These findings provide contextual information for researchers seeking to identify and test interventions that reflect LTC providers' priorities for PLWD and emphasize the need to align research priorities with provider priorities.

Dataset Information

Primary Care Pracitioner Perspectives on the Role of Primary Care in Dementia Diagnosis and Care.

Importance

Objective

Design, setting, and participation

Main outcomes and measures

Results

Conclusions and relevance

Publications

Primary Care Pracitioner Perspectives on the Role of Primary Care in Dementia Diagnosis and Care.

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